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Claims Analyst

2 months ago

Dartmouth, Canada Medavie Blue Cross Full time

Claims Analyst role involves reviewing and analyzing complex medical claims, ensuring accurate payment and maintaining current knowledge of policy and procedure changes.

Medavie Blue Cross is a leading health and wellness partner for individuals, employers, and governments across Canada, with a strong commitment to community investment and employee well-being.

As a Claims Analyst, you will work in a team environment, liaising with MSI Medical Consultants, staff, and management to resolve claims-related issues.

Key responsibilities include reviewing and analyzing complex claims, preparing medical claims for payment, and providing excellent customer service.

Required qualifications include post-secondary education in a health-related field, 2-3 years of related work experience, and strong computer skills, particularly in Microsoft Excel.

Core competencies include knowledge of customer needs, analytical thinking, communication skills, customer orientation, execution and organizational skills, and teamwork.

  • Review and analyze complex medical claims for accuracy and completeness
  • Prepare medical claims for payment and coding in accordance with the Nova Scotia Physicians Manual
  • Liaise with Service Providers to resolve claims-related issues
  • Provide excellent customer service through phone and email inquiries
  • Post-secondary education in a health-related field
  • 2-3 years of related work experience
  • Strong computer skills, particularly in Microsoft Excel
  • Bilingualism considered an asset
  • Demonstrates knowledge of customer needs and various processes and procedures
  • Uses business knowledge and experience to solve routine problems
  • Communicates clearly and confidently verbally and in writing
  • Regularly handles routine customer questions and problems independently
  • Organizes work and information in a well-thought-out manner to deliver on specific tasks and milestones